Provider Demographics
NPI:1992851448
Name:CINQUEMANI, SHARON (PT)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:CINQUEMANI
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53A WHITE BIRCH CIR
Mailing Address - Street 2:
Mailing Address - City:MILLER PLACE
Mailing Address - State:NY
Mailing Address - Zip Code:11764-2526
Mailing Address - Country:US
Mailing Address - Phone:631-476-0373
Mailing Address - Fax:
Practice Address - Street 1:691 ROUTE 25A
Practice Address - Street 2:
Practice Address - City:MILLER PLACE
Practice Address - State:NY
Practice Address - Zip Code:11764-2643
Practice Address - Country:US
Practice Address - Phone:631-821-7337
Practice Address - Fax:631-821-3588
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012044-12251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics